Cancer: An Inheritance That One Cannot Reject

13. September 2016
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How do ethnic or gender differences manifest as part of cancer risk? And what added value do doctors get from the respective information? These questions are being answered by researchers using long-term data collected from more than 1.3 million cancer cases in the Los Angeles area.

In producing their recently published report “Cancer in Los Angeles – Trends by Race/Ethnicity” scientists analysed more than 1.3 million cancer cases from 1976 to 2012. Various ethnic groups live in the region – this being a treasure trove for statisticians to analyse valid data. Working with the Los Angeles Cancer Surveillance Program (CSP), a database residing at the Keck School and the USC Norris Comprehensive Cancer Center. Each year 41,000 new records are added.

Not just black or white

Their conclusion: The risk of malignant diseases varies greatly with membership of a population group, with gender and age.

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Cancer cases in the region of Los Angeles, 1972 to 2012. Source: University of Southern California

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Cancer cases among different ethnic groups, each per 100,000 population, 1972 to 2012. Source: University of Southern California

Black men have the highest, black women the third highest overall rates of cancer. With them doctors find malignant disease on average twice as often in comparison to Asian populations. Cancer primarily afflicts the prostate, pancreas, kidney, bone marrow, the oesophagus and the larynx. Only with melanoma do black Americans have better outcomes, something altogether unsurprising. The statistical trend associated with malignant diseases of the prostate, of the oesophagus and larynx is a rather decreasing one, whereas carcinoma of the kidney has gained statistical significance.

The scientists found the highest overall cancer risk with women when looking at Hawaiians and Samoans. These risks include breast, lung and uterine cancer. Men in this ethnic group have to live with the second highest risk, compared with other groups. Endometrial carcinoma according to these numbers show the strongest rising tendency.

White non-Latinos in terms of their overall risk ranked in third place (men) and second place (women). The spotlight here falls on melanomas, Hodgkin and non-Hodgkin’s lymphoma, leukaemia, tumours of the bladder, the ovaries, the brain and the testes. Melanomas are becoming more common, whereas ovarian cancers occur more rarely.

In fourth position follow Vietnamese women and men. With them oncologists particularly frequently find liver and cervical carcinoma. For Vietnamese men as an overall group, lung cancer occupies the top position, closely followed by colorectal cancer. In the near future these ranking positions might swap over, researchers expect, on account of their numbers.

With white Latinos, Hodgkin’s lymphoma and renal carcinoma occurrence are statistically most significant; the trend is a rising one. Liver cancer, testicular cancer and thyroid cancer are increasing in numerical terms, whereas cervical or prostate cancers are occurring more rarely.

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Cancers of the lung, bronchus and prostate are showing increased occurrence in black men. Black women suffer more often from cervical cancer. Source: University of Southern California

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Whites of both sexes suffer more frequently from melanoma and non-Hodgkin’s lymphoma. Source: University of Southern California

Breast cancer – a recurring theme of oncology

With both black and white women, oncologists more frequently found breast cancers in recent decades. As part of an explanation, the authors of the report most prominently cite mammography screenings: these frequently involve instances of in-situ carcinoma. Latinas have significantly less access to screening programs. For them, the risk of breast cancer is generally lower, which could be due to traditional lifestyle habits. Alcohol and hormone supplementation following menopause are known risk factors. Women of Japanese or Filipino origins adapt rather more fully to American customs. This is also evident with breast cancer risk. The most dramatic upward trend is evident with Koreans. The researchers however still come up short with regard to an explanation on this point.

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Cancer tendencies among white non-Hispanic women. Source: University of Southern California

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Cancer tendencies among Koreans. Source: University of Southern California

Employing resources sensibly

A question remains: What do these numbers mean for the clinic? In this era of limited resources it is worth employing screening procedures with patients who stand to benefit the most. Black men benefit more from tactile examinations or PSA tests than do their white fellow males. And with Korean or Japanese people, doctors should reach sooner and more often for the gastroscope than with other ethnicities, so as to uncover gastric cancers as early as possible. People with fair skin get more from dermatological examinations. The key word here: melanoma risk.

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Medicine, Oncology, Research

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